Rebecca Glass volunteers at a rape crisis center and works closely with victims in the immediate aftermath of rape. Given all the rape allegations on the national stage, and, unfortunately, all the misinformation and badly-drawn conclusions by those with no experience in the field, Rebecca offered to take us through what she sees on a regular basis, including what a rape kit is and how it works. This is important information for everyone to know, regardless of your gender or whether you think you’ll ever been in a post-rape exam. Knowledge is power, the more you know, and all that good rot. Huge thanks to Rebecca for sharing her experience and expertise with us!
When you volunteer as an ER advocate for survivors of sexual assault and domestic violence, you learn a few things. This is my attempt to clear up some of the misconceptions people might have about sexual assault exams/rape kits, and the behaviors of survivors.
- Every survivor is different.
My survivors cross racial, age, socioeconomic, and disability lines. Many of my survivors were assaulted by someone they knew; some have memory lapses as a result of likely being drugged and no recollection of their assailant. Some survivors come to the ED on their own, some come with a friend, and some have come with relatives.
In my state, a survivor who is thirteen years or older can choose whether or not to report an assault to the police. Some of my survivors have done so, some chose not to, and some were unsure at the time of the exam if they wanted to or not.
Some survivors have no further contact with their assaulters, but as in many cases a sexual assault is perpetrated by someone the survivor knows, often times I will have a survivor asking me that “he’s trying to call/text me, what do I do?” Also, some assailants have used verbal threats to try and scare a survivor from reporting the crime.
- As every survivor is different, so is everyone’s coping mechanism.
Some survivors cry, some get angry, some remain relatively calm. Some survivors know exactly what they want (for example, the prophylactic medications but no forensic exam or police), while others are unaware of what’s involved in a sexual assault exam. Other survivors can be indecisive and feel overwhelmed by the information presented. Each step of the exam is done with the survivor’s consent, so while some make it through the whole exam, others have to stop at a certain point.
- The forensic exam is invasive and intense.
The “rape kit”, or forensic exam done to collect forensic evidence, generally starts relatively un-invasive with oral and buccal (cheek) swabs, and then proceeds to get more invasive, including photos of the genital area, a speculum exam and, if indicated, anal swabs. While a lot of what you see on Law and Order SVU is dramatized and exaggerated, it is fairly representative when it comes to the exam procedure. Or, at least, it was; I stopped watching after Chris Meloni left…
By the way, prophlyaxis — the drugs taken to prevent STDs and HIV/AIDS as well as pregnancy, if indicated, is no fun. The combination of antibiotics usually comes with a dose of anti-nausea medicine, and the HIV medication, while effective, has to be taken for 28 days, even though the risk of catching HIV is extremely small. The combination of medications can leave a survivor feeling nauseous and have other, unpleasant, side effects.
- The exam has a time limit, is dependent on a number of factors, and will not always yield DNA.
Generally, there’s a 96-hour time limit to collect forensic evidence, and the closer you get to that limit, the more degraded the evidence becomes. For a survivor’s best chance at evidence collection, they would need to arrive at the ER as soon after the assault as possible, and not have showered, bathed, brushed teeth, eaten anything, changed clothes, or, if wearing one, pantyliner or maxi pad. As many survivors either aren’t sure what they want to do right after the assault or are unconscious because of being drugged, there’s often some time that’s elapsed. Even if the exam is done promptly and correctly, there’s no guarantee DNA will be found.
Non-blood evidence can be stored in a hospital, but most hospitals don’t keep kits outside the six month-year window; thus a survivor can choose to have a kit done within the 96-hour window but decide to report the crime to police weeks or months later.
- In my state, a kit to test for drug-induced raped only gets processed if the crime is reported to police.
Testing for rohipnol and like drugs is expensive, and many cities and states have a backlog. A significant issue arises because these kits are only good for 30 days, and thus a survivor has a much smaller window to make a decision to report the crime or not.
- Speaking of the police, they’re trained to solve crimes, not to be compassionate.
Police interaction can be brusque and intimidating for survivors. Yes, I’ve seen detectives ask questions about what the survivor was wearing, and questions meant to get as many intimate details about the assault as possible. Sometimes a survivor is ready and willing to cooperate fully, other times I’ve had survivors have flashback and anxiety attacks. The police are trying to do a difficult job – catching the perpetrator – in the best way that they can, but it doesn’t always make it easy for the survivors.
Sometimes a survivor will withdraw a complaint—this doesn’t necessarily mean that the assault didn’t happen; it often times means that the survivor doesn’t feel ready to cope with an investigation. The drawback is that if a survivor decides to refile a complaint, his or her credibility as a witness is significantly damaged.
What I’ve detailed here doesn’t describe the whole “after” for a survivor of sexual assault; it just describes the few hours that the survivor spends in the ER. The actual healing process can take much longer—how much depends on the survivor, the assault, whether the police were involved, and a whole host of other factors. Yes, counseling services do exist, but they are often overwhelmed and underfunded — so if there’s a program in your area, and you’d like to help survivors of sexual violence, please consider supporting it in any way you can!
You can follow Rebecca on Twitter @rebeccapbp.